title: [Cervical maturation and induction of labor with PgE2 gel. Authors' experience].
abstract: BACKGROUND
  To evaluate the efficacy and safety of intracervical prostaglandin E2 gel applications (PgE2) for cervical ripening and induction of labor in relation to parity and admission cervical score.
  
  
  METHODS
  One hundred and thirty-nine hospitalized patients with an unfavorable cervix (Bishop score < or = 4) received a dose of commercially available endocervical dinoprostone gel 0.5 mg. On the basis of cervical scores, the gel was reapplied at a 12-hour interval for a maximum of two doses. If cervical ripening was successful (Bishop score > 4) but labor did not start within 12 hours from the last dose of gel, labor was induced with oxytocin infusion or with 1 or 2 doses of intravaginal dinoprostone.
  
  
  RESULTS
  Intracervical gel was effective for preparing an unfavorable cervix in 87.1% of patients. In 53.1% of nulliparous with admission Bishop < or = 2 the interval between the first application of gel and delivery was higher than 24 hours whereas in all patients with parity > or = 1 and initial Bishop score between 3 and 4 delivery was achieved within 24 hours. The cesarean delivery rates in the two groups were 23.9% and 43% respectively.
  
  
  CONCLUSIONS
  The interval from the first application of gel to delivery is strongly influenced by parity and initial cervical score. Vaginal delivery can be expected in four fifths of patients with an unfavorable cervix who undergo pre-induction cervical ripening with prostaglandin E2 gel.
authors.affiliation: Dipartimento di Discipline Chirurgiche, Clinica Ginecologica e Ostetrica, Università degli Studi, L'Aquila.
authors.forename: G
authors.initials: G
authors.lastname: Carta
authors.forename: M
authors.initials: M
authors.lastname: Vigilante
authors.forename: S
authors.initials: S
authors.lastname: Di Cesare
authors.forename: G
authors.initials: G
authors.lastname: Mascaretti
authors.forename: D
authors.initials: D
authors.lastname: Caserta
authors.forename: M
authors.initials: M
authors.lastname: Moscarini
mesh_terms: D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000187:drug effects*; D015232:Dinoprostone / Q000008:administration & dosage*; D005260:Female; D005782:Gels; D006801:Humans; D007751:Labor, Induced; D010298:Parity; D011247:Pregnancy
chemical_list: D005782:Gels; D015232:Dinoprostone
vernacular_title: Maturazione del collo uterino e induzione del travaglio di parto con PgE2 gel. Nostra esperienza.